Experience of Health Care Professionals Using Digital Tools in the Hospital: Qualitative Systematic Review

Abstract

Background The digitalization of health care has many potential benefits, but it may also negatively impact health care professionals’ well-being. Burnout can, in part, result from inefficient work processes related to the suboptimal implementation and use of health information technologies. Although strategies to reduce stress and mitigate clinician burnout typically involve individual-based interventions, emerging evidence suggests that improving the experience of using health information technologies can have a notable impact. Objective The aim of this systematic review was to collect evidence of the benefits and challenges associated with the use of digital tools in hospital settings with a particular focus on the experiences of health care professionals using these tools. Methods We conducted a systematic literature review following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines to explore the experience of health care professionals with digital tools in hospital settings. Using a rigorous selection process to ensure the methodological quality and validity of the study results, we included qualitative studies with distinct data that described the experiences of physicians and nurses. A panel of 3 independent researchers performed iterative data analysis and identified thematic constructs. Results Of the 1175 unique primary studies, we identified 17 (1.45%) publications that focused on health care professionals’ experiences with various digital tools in their day-to-day practice. Of the 17 studies, 10 (59%) focused on clinical decision support tools, followed by 6 (35%) studies focusing on electronic health records and 1 (6%) on a remote patient-monitoring tool. We propose a theoretical framework for understanding the complex interplay between the use of digital tools, experience, and outcomes. We identified 6 constructs that encompass the positive and negative experiences of health care professionals when using digital tools, along with moderators and outcomes. Positive experiences included feeling confident, responsible, and satisfied, whereas negative experiences included frustration, feeling overwhelmed, and feeling frightened. Positive moderators that may reinforce the use of digital tools included sufficient training and adequate workflow integration, whereas negative moderators comprised unfavorable social structures and the lack of training. Positive outcomes included improved patient care and increased workflow efficiency, whereas negative outcomes included increased workload, increased safety risks, and issues with information quality. Conclusions Although positive and negative outcomes and moderators that may affect the use of digital tools were commonly reported, the experiences of health care professionals, such as their thoughts and emotions, were less frequently discussed. On the basis of this finding, this study highlights the need for further research specifically targeting experiences as an important mediator of clinician well-being. It also emphasizes the importance of considering differences in the nature of specific tools as well as the profession and role of individual users. Trial Registration PROSPERO CRD42023393883; https://tinyurl.com/2htpzzxj

The Paradoxes of Digital Tools in Hospitals: Qualitative Interview Study

“…Overall, negative sentiments about the use of digital tools have been mentioned more often by HCPs (n=3018, 50.62% quotations) compared with positive (n=1636, 27.44% quotations) or neutral (n=1308, 21.94% quotations) reports. Compared with our previous literature review and derived theoretical framework [ 31 ], which included 6 dimensions impacting digital tool use, including moderators, outcomes, and experiences, each of a positive and negative nature, this study reported a similar distribution of digital tool moderators, outcomes, and experiences (n=2976). Investigating these 6 dimensions, overall, 61.32% (1825/2976) of reported factors are moderators that influence the use of digital tools in positive (883/2976, 29.67%) or negative (942/2976, 31.65%) ways; 31.65% (942/2976) are outcomes, either positive (438/2976, 14.72%) or negative (504/2976, 16.93%); and only 7.02% (209/2976) true experiences and emotions, with only 1.88% (56/2976) positive and 5.14% (153/2976) negative reports that impact the overall well-being of clinicians.…”

“…Unlike other research methods, qualitative interviews allow us to capture intricate aspects of individuals’ experiences, including their thoughts, emotions, opinions, and perspectives [ 36 - 38 ]. Switzerland was chosen as the study location partly due to the limited exploration of its diverse health care digitalization landscape [ 31 ]. Moreover, Switzerland’s health care system is decentralized; therefore, there are a variety of solutions implemented at different hospitals, offering a rich source of diverse experiences.…”

“…In previous research, we conducted a systematic review of the published qualitative literature on HCPs’ experiences using digital tools in hospitals, with the aim to collect evidence on their benefits and challenges, particularly focusing on their personal experiences [ 31 ]. In this context, our findings revealed that clinicians’ personal experiences were reported less frequently compared with the moderators or outcomes associated with the use of HIT and that these can often not be distinguished.…”

“…In this context, our findings revealed that clinicians’ personal experiences were reported less frequently compared with the moderators or outcomes associated with the use of HIT and that these can often not be distinguished. To delineate this distinction, we developed a theoretical framework that aimed to understand the complex interplay between the use of digital tools, encompassing positive and negative experiences, positive and negative moderators that possibly affect their adoption and use, and the resulting corresponding positive and negative effects and outcomes [ 31 ]. While outcomes of digital tools use in health care can encompass improved patient care, enhanced workflow efficiency, and increased information availability, moderators (eg, training quality and interface design) do exist, which can exert either positive or negative influences on tool use.…”

“…Furthermore, individual user experiences, comprising personal thoughts, emotions, and feelings, can be sharpened by both tool outcomes and use, consequently either fostering or impeding the adoption of digital tools. These direct emotional experiences when using technologies may account for the downstream impact on well-being [ 31 ].…”